14. Nutrition & Fluid Balance

Question 1

lack of proper nutrition that results from insufficient food intake or improper diet

Answer 1

malnutrition

Question 2

Name 6 problems that can affect nutritional intake

Answer 2

• dysphagia
• elderly produce less saliva (affects swallowing and leads to aspiration)
• medication GI side effects
• decrease in physical activity and mobility
• loss of ability to smell/taste/see food
• problems with mouth (teeth/dentures)

Question 3

Vegetarians vs vegans

Answer 3

• Vegetarians: don’t eat meat, fish, or poultry; may or may not eat eggs and dairy products
• Vegans: don’t eat any animals or animal products including dairy items or eggs

Question 4

T/F - honoring a resident’s food preferences is a legal responsibility of the facility

Answer 4

True

Question 5

Name 6 basic nutrients. Which one is the most essential for life?

Answer 5

• water (most essential)
• carbohydrates
• fats
• proteins
• vitamins
• minerals

Question 6

What 5 things does the MyPlate icon emphaseze?

Answer 6

• fruits
• vegetables
• grains
• protein
• low-fat dairy products

Question 7

What types of vegetables have the best nutritional content?

Answer 7

dark green, red, and orange vegetables

Question 8

What are vegetables a good source of?

Answer 8

• dietary fiber
• potassium
• vitamins A, B, C, and E

Question 9

What are fruits a good source of?

Answer 9

• dietary fiber
• folic acid
• potassium
• vitamin C

Question 10

Whole grains vs refined grains

Answer 10

• Whole grain: contain bran and germ as well as endosperm

- Refined grain: only contains endosperm

Question 11

Name 2 examples of seafood that is high in oils and low in mercury?

Answer 11

salmon and trout

Question 12

Name some plant sources of protein

Answer 12

beans, peas, soy products, nuts and seeds

Question 13

Sunflower seeds and almonds are good sources of what?

Answer 13

vitamin E

Question 14

Name 4 nutrients found in milk

Answer 14

calcium, potassium, vitamin D, and protein

Question 15

What is the role of the dietary department?

Answer 15

create food to match the diet ordered by the doctor while also taking into consideration the resident’s likes and dislikes and nutritional needs

Question 16

What is listed on a resident’s diet card?

Answer 16

• resident’s name
• info about special diets
• allergies
• likes and dislikes
• any other dietary instructions

Question 17

diet made up of foods that are in a liquid state at room temp; usually ordered as clear or full

Answer 17

liquid diet

Question 18

When may a liquid diet be ordered?

Answer 18

due to a medical condition or ordered before surgery or a diagnostic test

Question 19

diet made up of foods that are soft in texture and consists of foods that are easier to chew and swallow

Answer 19

soft diet or mechanical soft diet

Question 20

When may a soft diet be ordered?

Answer 20

used for people who are making the transition from a liquid diet to a regular diet; also used for people recovering from surgery or long illness or who have dental problems or extreme weakness

Question 21

diet made up of food that is blended or ground into a thick paste; food holds its form in the mouth but doesn’t need to be chewed

Answer 21

pureed diet

Question 22

When may a puree diet be ordered?

Answer 22

for people who have trouble chewing/swallowing and who cannot tolerate regular or mechanical soft diets

Question 23

diet in which foods that irritate the stomach and digestive tract are eliminated

Answer 23

bland diet

Question 24

When may a bland diet be ordered?

Answer 24

for people who have intestinal problems or conditions such as Crohn’s disease or gastric ulcers

Question 25

diet in which all products with lactose must be eliminated (includes milk and all foods or beverages made with milk)

Answer 25

lactose-free diet

Question 26

diet that increases the intake of fiber and whole grains

Answer 26

high-residue or high-fiber diet

Question 27

When may a high-fiber diet be ordered?

Answer 27

for people with bowel disorders such as constipation

Question 28

diet that decreases the intake of fiber

Answer 28

low-residue or low-fiber diet

Question 29

When may a low-fiber diet be ordered?

Answer 29

for people with bowel disorders such as diverticulosis

Question 30

diet that increases the amount of calories to help a person gain weight or decreases the amount of calories to help a person lose weight; common abbreviations are high-cal or low-cal

Answer 30

modified calorie diets

Question 31

When might a low-sodium (NAS) diet be ordered?

Answer 31

for people who have heart or kidney disease

Question 32

When might a high-protein diet be ordered?

Answer 32

for people recovering from surgery and for healing serious wounds such as burns

Question 33

When might a low-protein diet be ordered?

Answer 33

for people who have kidney or liver disease

Question 34

When might a low-fat/low-cholesterol diet be ordered?

Answer 34

for people who have heart disease or artery problems; also for people who have gallbladder or liver disease

Question 35

When might a high-potassium diet be ordered?

Answer 35

for people who take diuretics or BP medications (meds can cause low potassium level)

Question 36

When might a fluid-restricted diet be ordered? What is the abbreviation for this diet?

Answer 36

for people with severe heart disease or kidney disease (have trouble processing fluids); RF or Restrict Fluids

Question 37

T/F - Residents with DM must eat everything they are served

Answer 37

True

Question 38

Celiac disease vs gluten intolerance

Answer 38

- Celiac disease: causes damage to the intestines if gluten is consumed - Gluten intolerance: doesn't cause damage to the intestines but does cause ABD pain, gas, and diarrhea

Question 39

Describe each of the following: lacto-ovo vegetarian, lacto-vegetarian, ovo-vegetarian, and vegan diet

Answer 39

- lacto-ovo vegetarian: omits all meats but allows eggs and dairy - lacto-vegetarian: omits all meats and eggs, but allows diary - ovo-vegetarian: omits all meats and dairy products, but allows eggs - vegan diet: omits all poultry, meats, fish, eggs, and dairy products along with all foods that are derived from animals

Question 40

Is it better for residents with swallowing problems (such as dysphagia) to have thicker or thinner fluids?

Answer 40

thicker fluids are better; thinner fluids can increase the risk of choking

Question 41

Describe 3 types of thickened consistencies given to residents

Answer 41

- nectar thick: similar to nectar or tomato juice; can be drank through a straw - honey thick: will pour slowly and will need a spoon to consume - pudding thick: semi-solid consistency and will need a spoon to consume

Question 42

What is the appropriate position for residents when eating to prevent swallowing and choking problems?

Answer 42

upright at a 90 degree angle

Question 43

T/F - Residents who require the least amount of assistance with meals should be helped first

Answer 43

True

Question 44

How should you check the temperature of a food before serving it to a resident?

Answer 44

put your hand over the food to sense the heat; do not touch it or blow on it

Question 45

How should you respond if a resident refuses to eat their food?

Answer 45

respect this and don't insist that they eat but report it to the nurse immediately

Question 46

Name 2 types of cues used for residents with special needs

Answer 46

- physical cues such as hand-over-hand approach | - verbal cues

Question 47

For residents who have had a stroke, which side of their mouth should you put food into?

Answer 47

the stronger/unaffected side to prevent choking

Question 48

forceful protrusion of the tongue, often during eating and drinking

Answer 48

tongue thrust

Question 49

How long should residents be kept sitting upright after eating or drinking to prevent aspiration

Answer 49

at least 30 minutes

Question 50

Signs and sis of aspiration

Answer 50

gagging, vomiting, clutching throat, cyanosis, darkening skin, SOB, LOC, or complaints of chest pain or tightness

Question 51

What is included in output?

Answer 51

- urine - feces - vomit - perspiration - moisture in the air that a person exhales - suctioned material and wound drainage

Question 52

How many mL equal 1 oz?

Answer 52

30 mL

Question 53

T/F - If a resident eats less than 80% of their meal, you should report it to the nurse

Answer 53

False - report if they eat less than 70% of their meal

Question 54

order given to residents who risk dehydration; encourages them to drink more fluids

Answer 54

force fluids (FF)

Question 55

What is the acronym to encourage fluid intake? What does it stand for

Answer 55

- POURR - Post a regular schedule for offering fluids - Observe residents carefully for signs/sx of dehydration - Use other kinds of fluids (ice chips or frozen ice sticks) to increase fluid intake - Remind all staff, visitors, and volunteers as necessary the importance of following the schedule - Report changes in fluid balance or any signs/sx of dehydration promptly

Question 56

condition that occurs when more fluid enters the body than is eliminated

Answer 56

fluid overload

Question 57

order which means a person is allowed to drink bu must limit the daily amount to a level set by the doctor

Answer 57

restrict fluids (RF)